Rayess Hani M, Monk Ian, Svider Peter F, Gupta Amar, Raza S Naweed, Lin Ho-Sheng
1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
2 Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA.
Otolaryngol Head Neck Surg. 2017 May;156(5):794-802. doi: 10.1177/0194599817696504. Epub 2017 Mar 21.
Objective Although thyroglossal duct cysts (TGDCs) are relatively common, malignancies within these lesions are infrequent. As a result, there are no large-scale series describing clinical characteristics. Our objectives were to perform a systematic review of the literature evaluating patient demographics, pathology, management, and prognosis of these patients. Data Sources PubMed, Embase, Cochrane reviews, and Google Scholar were searched for relevant articles. Articles meeting inclusion criteria were reviewed for data detailing epidemiology, treatment, and outcomes. Review Methods Inclusion criteria included English-language articles with original reports on human subjects. Two investigators independently reviewed all articles for the data collected, including epidemiology, treatment, and outcomes. Results Ninety-eight articles comprising 164 patients were included in the final analysis. The mean age at presentation was 39.5 years (9-83 years); 68.3% of patients were female. In total, 73.3% of cases were found on final pathologic analysis. The most common pathology was papillary cancer (92.1%). Of the patients, 98.9% underwent a Sistrunk procedure and 61.0% underwent total thyroidectomy. There was a 4.3% recurrence rate with a mean time to recurrence of 42.1 months from initial treatment. One patient died of TGDC carcinoma, while all other patients were disease free at the time of last follow-up (mean follow-up was 46.1 months). Conclusion TGDC carcinoma is typically diagnosed on final pathology. While management encompasses a Sistrunk procedure, further consideration should be given to thyroidectomy among patients ≥45 years of age and individuals with aggressive disease. TGDC carcinoma harbors an exceedingly low rate of mortality.
目的 尽管甲状舌管囊肿(TGDCs)相对常见,但这些病变内的恶性肿瘤并不常见。因此,没有大规模系列研究描述其临床特征。我们的目的是对评估这些患者的人口统计学、病理学、治疗和预后的文献进行系统综述。
数据来源 在PubMed、Embase、Cochrane综述和谷歌学术中搜索相关文章。对符合纳入标准的文章进行审查,以获取详细的流行病学、治疗和结局数据。
综述方法 纳入标准包括关于人类受试者原始报告的英文文章。两名研究者独立审查所有文章,收集包括流行病学、治疗和结局的数据。
结果 最终分析纳入了98篇文章,共164例患者。就诊时的平均年龄为39.5岁(9 - 83岁);68.3%的患者为女性。最终病理分析发现73.3%的病例。最常见的病理类型是乳头状癌(92.1%)。98.9%的患者接受了Sistrunk手术,61.0%的患者接受了甲状腺全切除术。复发率为4.3%,从初始治疗到复发的平均时间为42.1个月。1例患者死于TGDC癌,而所有其他患者在最后一次随访时无疾病(平均随访46.1个月)。
结论 TGDC癌通常在最终病理检查时确诊。虽然治疗包括Sistrunk手术,但对于≥45岁的患者和患有侵袭性疾病的个体,应进一步考虑甲状腺切除术。TGDC癌的死亡率极低。